With three different medical
cannabis bills submitted to parliament in 2018 (National
released their draft Bill yesterday), the punter could be
forgiven for not knowing exactly what is going on here. The
reality is, it is all pretty confusing. It certainly
doesn’t help that our Parliamentary system is so
adversarial that the parties can’t just work together
rather than draft Bills at cross purposes in some sort of
‘mine is better than yours’ game. There are good and bad
elements of all three of these bills. There are also very
dangerous and unjust intentions behind National’s new
Bill, as I will explain. Spoiler alert: it involves
neoliberal capitalism and the ‘big pharma’ industry.
What is clear is that the public and patients in need are
fed up with the bickering and self-serving politics. What we
want is a progressive, patient and human rights centred
cannabis policy, and we want it yesterday.

So, after
hearing from hundreds of patients and caregivers, as well as
medical groups and patient advocates, the Health Select
Committee reported back yesterday on possible changes to the
Misuse of Drugs (Medicinal Cannabis)
Amendment Bill. The full report is available on
Scoop here. Unsurprisingly, the
overwhelming majority of submitters were in favour of the
Bill, however most expressed concern at its limited scope.

With impeccable timing, a Curia poll released this week by the
New Zealand Drug Foundation found 89 per cent support for
allowing medicinal cannabis for terminally ill patients, and
87 per cent support for chronic pain relief. However the
Bill as tabled by Labour de-schedules CBD and only creates a
compassionate exception for terminally ill patients to
possess cannabis (not chronically ill patients). The Bill is
very light on actual substance as to how patients will
access said medicine, leaving this to a regulatory framework
to be determined by the Ministry of Health (MOH).

In
fact, the select committee framing was so narrow that these
details were not even considered, leading one to question
why the process took so many months. This vagueness has
created an opening to National MP Shane Reti drafting his
own law and submitting it under the ballot system. You know
something is wrong when National comes up with what is
possibly a more comprehensive cannabis law than this
supposedly ‘progressive’ Labour Government.

However,
National certainly did not do so for the good of patients as
they claim. No, if you read the fine print, this Bill is
actually a cynical attempt to railroad the medical cannabis
regime into the big-pharma focused direction that National
would prefer to see it head. It is also a cheap shot and
attempts at political point scoring and cynical politics.

A spoonful of compassion helps the legislation go
down

Just what exactly David Clark and this
select Committee have been doing on Cannabis is unclear, but
in substance it amounts to next to nothing right now.

The
Select Committee report recommends in favour of a
‘compassionate exclusion’ from the MOD Act for
terminally ill patients to possess cannabis. It also
recommends removing CBD products from the Act, a good step
but hardly radical – CBD has no psychoactive compounds and
never should have been included in the Act.

However,
despite overwhelming support from the public submitters, the
committee refused to extend the ‘compassionate’ (spew!)
provision to people in chronic pain or with chronic illness
and chronic pain. Clearly their ‘compassion’ quota for
the year ran dry. Can’t use it all at
once.

Kicking the can-nabis down the
road…again

This weak attempt at legislation by
Labour will do next to nothing for true medical access to
cannabis products in the immediate term. It is essentially
kicking the can down the road again to the Ministry to come
up with a regime around medical cannabis with zero public
scrutiny. Why the details of this regime were not included
in the original Bill or the select committee terms of
reference that have wasted months to achieve very little is
unfathomable. Anyone would think they didn’t want public
input into the process. Instead the task has been passed on
to MOH by the Bill proposing to:

“provide a
regulation-making power to enable the setting of standards
that products manufactured, imported, or supplied under
licence must meet. The creation of a regulation-making power
would facilitate the development of a Medicinal Cannabis
Scheme. The scheme’s aim would be to provide a greater
supply of quality medicinal cannabis products by enabling
domestic cultivation and manufacture.”

On the
Regulation of medicinal cannabis products the report states:
“The setting of quality standards will be led by the
Ministry of Health, and will be informed by approaches taken
in other jurisdictions, expert technical advice, and
stakeholders.”

Remember that this is the same Ministry
of Health that Helen Clark has accused of burying the
Woodbridge report it commissioned which made
positive statements on the benefits of medical cannabis back
in 2008. How can the public have trust that they are going
to create standards that take interests of patients into
account this time around? How long will we wait for this new
regime? No clear timeframe has been given and consultation
has not yet begun. Labour claims this is in order to give
greater flexibility to the Ministry to adapt to a changing
environment. As Health Minister David Clark said yesterday:

“It may well put restrictions around the regulatory
body and compromise their ability to do their job in a fast
moving, fast changing market — I wouldn’t want to
compromise the regulator.”

However, to date the
Ministry has not proven its ability to keep pace with a
snail on this issue, and as a result is way behind most
other Western countries on medical cannabis. We are still
stuck with hugely expensive products after years of
supposedly legal medical cannabis on the books. As Tadhg
Stopford, Foundation Leader of the Hemp Foundation says:

“Here in NZ the
Ministry of Health is also insisting that we run an
‘evidence based system’ for which it provides the
evidence, which is a worry. Because they’ve been
suppressing evidence and misleading government for at least
ten years.”

This non transparent approach taken
by labour to developing a regime is now leaving an opening
for National to claim the moral high ground and play
political games by claiming their Bill is superior. Spoiler
alert, it is not. However, already the confusion is damaging
public and political support for Labour’s
approach.

Progress on non-pharmaceutical medical
cannabis at last?

Although the Bill and the
report have precious little detail on the regime to be
introduced for medical cannabis, there are positive signs in
the report that a more sensible approach to regulation of
cannabis outside of the pharmaceutical system may finally be
taken by MOH. In the ‘Labour Party View’ section of the
report it states as follows:

“Allowing the
Government to make regulations to set quality standards for
medicinal cannabis products.

The majority of
products likely to be available as part of a medicinal
cannabis scheme will be unconsented. We want to ensure that
products on the market are made to a standard that allows
them to be prescribed and consumed with confidence….The
overall standard for medicinal cannabis products is not
expected to match that of pharmaceutical grade products,
e.g. manufacturers will not be required to provide clinical
trial data. Standards will however cover the manufacturing
process and end product quality, and will apply to all
products manufactured domestically and imported. The setting
of quality standards will be led by the Ministry of Health,
and will be informed by approaches taken in other
jurisdictions, expert technical advice, and
stakeholders.”

Now, this highlighted sentence part
buried deep in the report is actually one of the most
important points to come out of the report, as at long last
it is recognition by the Government of the fact that the
standards around medical cannabis do not need to
meet a pharmaceutical standard. This is the crux of
the difference between the National Party approach as
unveiled yesterday, and exactly why National’s Bill is a
dangerous and predictable response from a neoliberal party
with the hands of the big-pharma industry in its pockets.

National Bill, Nice try but no
thanks

Shane Le Brun of MCANZ believes the
National Bill is a big step forward for them, and has a lot
more detail than the labour Bill:

“The size and scope
of the bill reflects a significant amount of time, hundreds
of hours, and international expertise being pulled in to `Do
it once, do it right`, as opposed to David Clark’s hands
off, 0 detail approach which has suffocated on a lack of
resources”

Le Brun also points out that MOH is
already falling behind on their self imposed deadlines and
no consultation is yet in play on the to be drafted
regulations.

However, Le Brun also raises concerns over
the National Bill’s treatment of the back end of
cultivation and production, stating:

“it doesn’t
address import or exports, onboarding local illicit cannabis
into the legal supply chain, and the bill is vague about the
single most deciding factor, of standards versus product
costs.”

Le Brun also states that the most
disappointing aspect of the National Bill is “the
scrapping of any form of compassionate clause, for the tens
of thousands of ill people who don’t deserve to be
criminalized.”

Why I still supporting
Labour’s Bill – even though it is
inadequate

The Labour Bill, although vague on
detail at this stage at least indicates that near
pharmaceutical products such as those allowed in Canada will
be part of the new MOH medical cannabis regime once it is
drafted. This is very important as Le Brun states:

“MCANZ has a strong preference for Canada’s
“Near pharmaceutical” standards of “GPP”. MCANZ has
had 4 separate products approved for individual patients
made to that standard, and deemed acceptable by Medsafe”.

It is just a shame Labour did not have the confidence
to actually put a provision in the Bill stating that a
non-pharmaceutical standard would be followed. This approach
essentially opens up the possibility of future Governments
changing the regulations to require a pharmaceutical
standard.

Importance of avoiding a big pharma
approach

Why is National so interested all of a
sudden after doing nothing during their decade of
rule?

Apart from the political expediency of supporting
something that nearly 90% of New Zealanders want,
essentially, it is money. The National Party Bill
predictably continues their neoliberal and paternalistic
stance of regulation through the corrupt pharmaceutical
regime that has gotten us into this mess. It is clear to
anyone following the issue of the past decade that the
National Party has deep ties to the big pharma industry, the
biggest industry and most voracious lobby group in the
world. This group, and hence national stands to lose a lot
of money from true cannabis reform as it will reduce profits
from expensive opioid pain killers and many other
medications. Evidence from overseas markets has already
borne out this prediction. As Tadgh Stopford wrote today: "in the legal US states, doctors are prescribing, on average, 4500 less prescriptions a year, most of them for pain. That’s about a billion NZ dollars in savings."
It seems the last desperate grasp at profits of this industry has been a power play to at least control the cannabis industry by requiring stringent pharmaceutical
standards.

Any law stating that cannabis medicines
must meet pharmaceutical guidelines is ridiculously
counter-factual, outdated and counterproductive. In fact
amounts to not legalising cannabis at all for the majority
of patients in need because it means medication costs
patients $30,000 per year. This is because getting such
pharmaceutical certification is expensive… really f***ing
expensive.

This pharmaceutical approach rules out the
production of cheap ‘food grade’ products on the local
market and destroys any chance of a local medical cannabis
industry emerging as a competitor in the global market. The
hypocrisy of the big pharma players now pushing for a law
requiring such an approach is pointed out by Le
Brun:

“Despite promises made by inexperienced
speculative Cannabis producers during the select committee
process, “Pharmaceutical grade” or “GMP” adds a
significant cost burden, and foreign companies such as
Bedrocan operated for many years before obtaining that
standard. To demand it upfront would handicap patient access
by adding costs and potentially an additional year of time
before companies are productive.”

However, the
reality is, there is very little (if any) difference in
substance between the expensive big-pharma cannabis brands
like Bedrocan and ‘near pharmaceutical grade’ products.
Pharmaceutical cannabis products are no more
‘scientific’ or refined than any of the ‘food grade’
certified products allowed in countries such as Canada
available for a fraction of the price.

Despite what
National and Pharmaceutical lobbyists will tell you, there
is no magic going on here other than the magic already
present in the plant. As Tadhg Stopford, Foundation Leader
of the Hemp Foundation points out in his open letter to Dr Stewart Jessamine,
the raw cannabis plant without processing contains the
cannabinoids that provide health benefits by interacting
with our unique internal Human Endocannibanoid
System:

“Our bodies use a 'wi-fi system' to maintain
our health and protect us from injury. This ‘wi fi’
system connects all of our organ and tissue systems. These
connections enable our health to be maintained through 'on
demand' regulation. Obviously this wifi system doesn’t use
radio, it uses fatty molecules called cannabinoids. That’s
why it is called our cannabinoid system.”

The
massive costs are all in the pharmaceutical grade testing
and patenting process. These are then of course passed on to
consumers. However this is not necessary. These drugs are
just the raw cannabinoids CBD and THC in different ratios,
no magic is required. The truth is people can make quality
cannabis CBD or THC extractions in their own homes, and have
been doing so for years. Sure quality and safety may vary,
but a simple food grade certification would solve any safety
issues on that front and ensure verification of CBD/THC
ratios as labelled.

Please, let’s not fall again for
the line National have trotted out for a decade now. It is
misdirection plain and simple and excuse making to cover up
their real motivations of maintaining pharmaceutical control
over the budding industry (pun definitely
intended.)

Cannabis lobby group, NORML also believe there
are merits to National's proposed scheme, but state that
regulating medicinal cannabis like pharmaceuticals could
keep products unaffordable – forcing patients to continue
turning to the black market. Spokesperson Chris Fowlie, who
is also CEO of PharmaCann New Zealand Ltd stated:
"National's proposals could allow local producers to
overtake Australia, but their restrictions could also hobble
our budding industry before it's even begun."

Phil
Saxby, a former Registrar of the Medical Laboratory Science
Board also stated: "As well as pharmaceutical products,
we need cheaper, food-grade cannabis products to be
available here, as they are in other countries."

Failure of a Bill or regime to provide this
providion for ‘food grade’ products, would simply
continue the status quo of holding New Zealand patients to
ransom with the most expensive and inaccessible cannabis
based medicine available anywhere in the world.

The path forward –
Collaboration

There is no guarantee that the
National bill will ever be heard by parliament, as it may
never be drawn from the ballot. Meanwhile, the Labour Bill,
as it is will not provide relief for patients in need in an
expedient manner. The irony of all this is that the Greens
Bill, already roundly dismissed by these Parties was in fact
a superior Bill than both of these and far more
comprehensive and compassionate. A mix of the three
different approaches may well be what is required. The
so-called coalition parties should now get together and hash
out their differences and come to an understanding about a
Bill that they (and NZ First) can support that incorporates
elements of the Greens and National Bills and greatly
expands the Labour Bill.

Thankfully the Green party
seems to agree with this need for greater action and
hopefully can sway the Government to be more open-minded and
collaborative on this issue. Green Party Sensible Drug Law
Reform spokesperson, Chlöe Swarbrick, said
yesterday:

“With 87% of New Zealanders in
support of cannabis liberalisation for pain relief, the
Health Select Committee now has a mandate to broaden the
Government’s Medicinal Cannabis Bill to help those living
with pain, not just those with a terminal
illness.”

NORML also issued a press statement
today saying: “Changes to the Government's medicinal cannabis bill don't go far
enough, while the National Party's proposed new bill could
mean only expensive pharmaceutical-style products are
available.

As Chris Fowlie stated yesterday: "It's
great they're now competing to have the best law …But we
need to keep the focus on patients, and that means no more
delays.”

In similar vein Rebecca Reider, who has
debilitating chronic pain and serves as a patient
representative on NORML's board says: “We need the
parties to work together now to fix the proposed legislation
and give patients urgent protection…While they squabble
patients are still getting busted, or dying without
medicine."

The first 100 days is well and truly up,
and it is time for real action now. People in pain and with
treatable chronic illnesses are suffering and growing tired
of the continued inaction and misinformation on this issue.
If National’s Bill shows anything, it is that making
legislation on this issue is really not as complicated as
they have been making it. This hopefully serves as a
motivation for the Government who have smugly been refusing
to listen to the activists and campaigners calling for more
action now. What we need is a patient centred and human
rights centred approach to medical cannabis ensuring access
for all chronic pain and illness sufferers at affordable
prices. It needn’t be this complicated or politicised.

Joseph Cederwall is Co-editor and Community Engagement Manager at Scoop Publishing. He is a writer and journalist with an interest in 'the commons', participatory democracy, social justice and human rights. He is a Director and Secretary of Freerange Cooperative - an international publishing cooperative. Joseph is also a contributor to Enspiral - a non-hierarchical collective of freelancers and ventures dedicated to collaborative business practice and making social impact through enterprise. With qualifications in law and anthropology Joseph has previously worked in the Immigration and Human Rights field as a lawyer and advocate.

ALSO:

In the circumstances, yesterday’s move by Lam to scrap – rather than merely suspend – the hated extradition law that first triggered the protests three months ago, seems like the least she can do. It may also be too little, too late. More>>

The DOC-led draft Biodiversity Strategy seeks a “shared vision.” But there are more values and views around wildlife than there are species. How can we hope to agree on the shape of Aotearoa’s future biota? More>>

We are in a moment of existential peril, with interconnected climate and biodiversity crises converging on a global scale to drive most life on Earth to the brink of extinction… These massive challenges can, however, be reframed as a once in a lifetime opportunity to fundamentally change how humanity relates to nature and to each other. Read on The Dig>>